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<HTML><HEAD><TITLE>Test Update</TITLE>

<TABLE>
  <TBODY>
  <tr>
    <td colSpan=3></td></tr>
  <tr>
    <td vAlign=center align=right colSpan=3 height=40>
      </td></tr>
  <tr>
    <td vAlign=center align=right width=200 bgColor=#333366 height=20><FONT 
      color=#ffffff>test name:</FONT></td>
    <td vAlign=center align=left bgColor=#333366 height=30>
    
    </td>
    <td bgColor=#333366 height=20>&nbsp;</td></tr>
  <tr>
    <td style="height: 14px" colspan="3">&nbsp;</td></tr>
  <tr>
    <td align=right>price estimate:</td>
    <td colpan="2">$ <INPUT size=10 value=8.00 name=Price_Estimate> 
      &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<FONT 
      color=#999999><B>to</B> (optional) $:</FONT> <INPUT size=10 
      name=Price_Upper> </td></tr>
  <tr>
    <td align=right>testing schedule:</td>
    <td><SELECT name=Testing_Schedule_ID> <OPTION value=0>*** select 
        ***</OPTION> <OPTION value=44>samples batched, minimum 6 month 
        TAT</OPTION> <OPTION value=2>Monday through Friday</OPTION> <OPTION 
        value=3>Tuesdays and Thurdays</OPTION> <OPTION 
        value=4>Mondays/Wednesday/Friday</OPTION> <OPTION value=5>Requires Lab 
        Approval</OPTION> <OPTION value=6>2x or 3x per week</OPTION> <OPTION 
        value=7>2-3 times per week</OPTION> <OPTION value=8>Monday to 
        Friday</OPTION> <OPTION value=9>Weekly</OPTION> <OPTION 
        value=10>Monthly</OPTION> <OPTION value=11>Biweekly</OPTION> <OPTION 
        value=12>Every 2 months</OPTION> <OPTION value=13 
        selected>Daily</OPTION> <OPTION value=14>on demand</OPTION> <OPTION 
        value=15>on demand</OPTION> <OPTION value=16>3 weeks</OPTION> <OPTION 
        value=17>2 weeks</OPTION> <OPTION value=18>once a week</OPTION> <OPTION 
        value=19>referred out</OPTION> <OPTION value=20>0900 - 1500 hrs</OPTION> 
        <OPTION value=21>1 week</OPTION> <OPTION value=22>Wednesdays and 
        Fridays</OPTION> <OPTION value=23>Monday through Friday 0900-1500 
        hrs</OPTION> <OPTION value=24>3 weeks</OPTION> <OPTION value=25>Living 
        donor - Booking required (416-340-4995)</OPTION> <OPTION value=26>Monday 
        to Friday 0730-1730</OPTION> <OPTION value=27>every 10 days</OPTION> 
        <OPTION value=28>every 5 days</OPTION> <OPTION value=29>on request, but 
        must be a minimum of 25 samples</OPTION> <OPTION value=30>4 week prior 
        arrangement</OPTION> <OPTION value=31>Tuesday to Friday 
        0800-1700</OPTION> <OPTION value=32>Monday to Friday before 
        1300</OPTION> <OPTION value=33>Every 15 days</OPTION> <OPTION 
        value=34>Monday - Thursday (0900-1700), Friday (0900-1200)</OPTION> 
        <OPTION value=35>Monday to Friday (0900-1800)</OPTION> <OPTION 
        value=36>8 week prior arrangement</OPTION> <OPTION value=37>twice a 
        week</OPTION> <OPTION value=38>Monday - Thursday (0900-1500), Friday 
        (0900-1200)</OPTION> <OPTION value=39>Monday to Saturday</OPTION> 
        <OPTION value=40>Discontinued</OPTION> <OPTION value=41>10 Days</OPTION> 
        <OPTION value=42></OPTION> <OPTION value=43></OPTION> <OPTION 
        value=45>Monday to Friday (08:00 - 22:00)</OPTION> <OPTION 
        value=46>Monday to Friday 9 am to 2 pm</OPTION> <OPTION value=47>Monday 
        to Thursday 08:00-12:00</OPTION></SELECT> </td>
    <td><A 
      href="https://intranet.uhn.ca/hospitals_associates/tml/LabDictionary/admin_tool/schedule.asp?DIVISION_ID=2&amp;alpha=c&amp;TEST_ID=368&amp;Testing_Schedule_ID=13"></A></td></tr>
  <tr>
    <td align=right>secondary schedule(if necessary):</td>
    <td><SELECT name=Testing_Schedule2_ID> <OPTION value=0 selected>* n/a 
        *</OPTION> <OPTION value=44>samples batched, minimum 6 month 
        TAT</OPTION> <OPTION value=2>Monday through Friday</OPTION> <OPTION 
        value=3>Tuesdays and Thurdays</OPTION> <OPTION 
        value=4>Mondays/Wednesday/Friday</OPTION> <OPTION value=5>Requires Lab 
        Approval</OPTION> <OPTION value=6>2x or 3x per week</OPTION> <OPTION 
        value=7>2-3 times per week</OPTION> <OPTION value=8>Monday to 
        Friday</OPTION> <OPTION value=9>Weekly</OPTION> <OPTION 
        value=10>Monthly</OPTION> <OPTION value=11>Biweekly</OPTION> <OPTION 
        value=12>Every 2 months</OPTION> <OPTION value=13>Daily</OPTION> <OPTION 
        value=14>on demand</OPTION> <OPTION value=15>on demand</OPTION> <OPTION 
        value=16>3 weeks</OPTION> <OPTION value=17>2 weeks</OPTION> <OPTION 
        value=18>once a week</OPTION> <OPTION value=19>referred out</OPTION> 
        <OPTION value=20>0900 - 1500 hrs</OPTION> <OPTION value=21>1 
        week</OPTION> <OPTION value=22>Wednesdays and Fridays</OPTION> <OPTION 
        value=23>Monday through Friday 0900-1500 hrs</OPTION> <OPTION value=24>3 
        weeks</OPTION> <OPTION value=25>Living donor - Booking required 
        (416-340-4995)</OPTION> <OPTION value=26>Monday to Friday 
        0730-1730</OPTION> <OPTION value=27>every 10 days</OPTION> <OPTION 
        value=28>every 5 days</OPTION> <OPTION value=29>on request, but must be 
        a minimum of 25 samples</OPTION> <OPTION value=30>4 week prior 
        arrangement</OPTION> <OPTION value=31>Tuesday to Friday 
        0800-1700</OPTION> <OPTION value=32>Monday to Friday before 
        1300</OPTION> <OPTION value=33>Every 15 days</OPTION> <OPTION 
        value=34>Monday - Thursday (0900-1700), Friday (0900-1200)</OPTION> 
        <OPTION value=35>Monday to Friday (0900-1800)</OPTION> <OPTION 
        value=36>8 week prior arrangement</OPTION> <OPTION value=37>twice a 
        week</OPTION> <OPTION value=38>Monday - Thursday (0900-1500), Friday 
        (0900-1200)</OPTION> <OPTION value=39>Monday to Saturday</OPTION> 
        <OPTION value=40>Discontinued</OPTION> <OPTION value=41>10 Days</OPTION> 
        <OPTION value=42></OPTION> <OPTION value=43></OPTION> <OPTION 
        value=45>Monday to Friday (08:00 - 22:00)</OPTION> <OPTION 
        value=46>Monday to Friday 9 am to 2 pm</OPTION> <OPTION value=47>Monday 
        to Thursday 08:00-12:00</OPTION></SELECT> </td>
    <td><A 
      href="https://intranet.uhn.ca/hospitals_associates/tml/LabDictionary/admin_tool/schedule.asp?DIVISION_ID=2&amp;alpha=c&amp;TEST_ID=368&amp;Testing_Schedule_ID=13"></A></td></tr>
  <tr>
    <td align=right>(web) turn-around-time:</td>
    <td><SELECT name=web_TAT_ID> <OPTION value=0>*** select ***</OPTION> 
        <OPTION value=1 selected>1 day</OPTION> <OPTION value=2>2 days</OPTION> 
        <OPTION value=3>3 days</OPTION> <OPTION value=4>5 days</OPTION> <OPTION 
        value=5>7-10 days</OPTION> <OPTION value=6>14 days</OPTION> <OPTION 
        value=7>20 days</OPTION> <OPTION value=8>30 days</OPTION> <OPTION 
        value=9>determined on an individual basis</OPTION></SELECT> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td vAlign=center align=right>clinical description:</td>
    <td><TEXTAREA name=Clinical_Description rows=4 wrap=VIRTUAL cols=42 id="TEXTAREA1" onclick="return TEXTAREA1_onclick()">Includes hemoglobin, hematocrit, red cell count, leukocyte count, platelet count, red cell indices, leukocyte differential.</TEXTAREA> 
    </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td vAlign=center align=right>references:</td>
    <td><TEXTAREA name=docreferences rows=3 wrap=VIRTUAL cols=42></TEXTAREA> 
    </td>
    <td>&nbsp;</td></tr><!--reference ranges for web - these are friendlier & simpler than the 'real' reference ranges elsewhere in the database. If the ranges are too complex, the user can add a standardized disclaimer -->
  <tr vAlign=center align=middle bgColor=#666666>
    <td colSpan=3>
      <P><FONT color=#ffffff>Reference Ranges:<BR>please enter a reference range 
      <I>summary</I> for web customers in the following format:<BR><B>0.24 - 
      0.70 g/L</B><BR>If there are two ranges (e.g. 'male' &amp; 'female') 
      separate them with a RETURN.<BR><B>male: 0.24 - 0.70 g/L<BR>female: 0.28 - 
      0.80 g/L</B><BR>If there are more than two ranges (e.g. multiple age &amp; 
      gender categories), please use the menu to add a complex range 
      disclaimer.</FONT></P></td></tr>
  <tr vAlign=center align=middle bgColor=#666666>
    <td>&nbsp;</td>
    <td align=left><SELECT onchange=updateTextField() name=disclaimers> 
        <OPTION selected>**select a complex range disclaimer**</OPTION> <OPTION 
        value="Reference ranges for this test are not available online. However, they are included in all test results. For more information, please call us.">Reference 
        ranges for this test are not available online...</OPTION> 
        <OPTION>**clear reference ranges field**</OPTION></SELECT> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td vAlign=center align=right bgColor=#cccccc>(web) reference ranges:</td>
    <td vAlign=center align=left bgColor=#cccccc><TEXTAREA name=web_ref_range rows=3 wrap=VIRTUAL cols=42>Reference ranges for this test are not available online. However, they are included in all test results. For more information, please call us.</TEXTAREA> 
    </td>
    <td vAlign=center align=right bgColor=#cccccc>&nbsp;</td></tr>
  <tr vAlign=baseline align=middle bgColor=#666666><!--this reveals the 'real' reference ranges, so that the user has an idea what to enter for the 'web' reference ranges -->
    <td vAlign=center colSpan=3><FONT color=#ffffff>The reference ranges used 
      internally are included below as reference (although special formatting is 
      used).</FONT></td></tr>
  <tr vAlign=baseline bgColor=#cccccc>
    <td vAlign=center align=right>(internal) reference ranges:</td>
    <td vAlign=center align=left><BR>
      <SCRIPT language=JavaScript>
var strRange1='';
var strRange2='';
var strRange3='';
var strRange4='';
var strRange='Hb;140-180;g/L;M;;Hb;120-160;g/L;F|Lkc;4.0-11.0;E+9/L;;;;;;|Plt;150-400;E+9/L;;;;;;|MCV;80-95;fL;;;;;;|RDW;11.5-14.8;;;;;;;|ERC;4.5-6.5;E+12/L;M;;ERC;3.9-5.6;E+12/L;F|PCV;0.40-0.54;L/L;M;;PCV;0.33-0.47;L/L;F|MCH;27.0-32.0;pg;;;;;;|MCHC;320-360;L/L;;;;;;|NEUT;2.0-7.5;E+9/L;;;;;;|LYMPH;1.5-4.0;E+9/L;;;;;;|MONO;0.2-0.8;E+9/L;;;;;;|EOS;0.04-.4;E+9/L;;;;;;|BASO;0.01-0.1;E+9/L;;;;;;'
var semi=';'
array1=strRange.split(semi)
for (var x=0;x<(array1.length);x++){
strRange1= strRange1 + array1[x] + '</small></span></td><td><span class=instruction><small>'
}
var colon=':'
array2=strRange1.split(colon)
for (var x=0;x<(array2.length);x++){
strRange2=strRange2 + array2[x] + '</small></span></td><td colspan=3><span class=instruction><small>'
}
var bar='|'
array3=strRange2.split(bar)
for (var x=0;x<array3.length;x++){
strRange3= strRange3 + array3[x] + '</small></span></td></tr><tr><td><span class=instruction><small>'
}
var comma=','
array4=strRange3.split(comma)
for (var x=0;x<array4.length;x++){
strRange4= strRange4 + array4[x] + '</small></span></td></tr><tr><td><span class=instruction><small>'
}
document.write('<table border=1><tr><td><span class=instruction><small>')
document.write (strRange4)
document.write('</small></span></td></tr></table>')
function TEXTAREA1_onclick() {

}

  </SCRIPT>
    </td>
    <td vAlign=center align=right>&nbsp;</td></tr>
  <tr vAlign=baseline bgColor=#cccccc>
    <td vAlign=center align=right>(internal) reference ranges (edit here):</td>
    <td><TEXTAREA style="FONT-SIZE: 7pt; FONT-FAMILY: Verdana" name=REFRANGE rows=3 cols=90>Hb;140-180;g/L;M;;Hb;120-160;g/L;F|Lkc;4.0-11.0;E+9/L;;;;;;|Plt;150-400;E+9/L;;;;;;|MCV;80-95;fL;;;;;;|RDW;11.5-14.8;;;;;;;|ERC;4.5-6.5;E+12/L;M;;ERC;3.9-5.6;E+12/L;F|PCV;0.40-0.54;L/L;M;;PCV;0.33-0.47;L/L;F|MCH;27.0-32.0;pg;;;;;;|MCHC;320-360;L/L;;;;;;|NEUT;2.0-7.5;E+9/L;;;;;;|LYMPH;1.5-4.0;E+9/L;;;;;;|MONO;0.2-0.8;E+9/L;;;;;;|EOS;0.04-.4;E+9/L;;;;;;|BASO;0.01-0.1;E+9/L;;;;;;</TEXTAREA> 
    </td>
    <td><A onclick=Preview_Table(REFRANGE) href="javascript:;"></A></td></tr>
  <tr vAlign=baseline bgColor=#cccccc>
    <td vAlign=center align=right>(web) conversion factor:</td>
    <td vAlign=center align=left>
      <DIV align=left><SELECT name=ref_conv_ID> <OPTION value=0 selected>*** 
        select ***</OPTION> <OPTION value=1>mg/dL x 0.0259</OPTION></SELECT> 
    </DIV></td>
    <td vAlign=center align=right>&nbsp;</td></tr><!--end of web reference ranges section -->
  <tr vAlign=baseline bgColor=#666666>
    <td vAlign=center align=right colSpan=3>&nbsp;</td></tr>
  <tr>
    <td align=right>method used:</td>
    <td><SELECT name=method_ID> <OPTION value=0>*** select ***</OPTION> 
        <OPTION value=1>Nephelometry</OPTION> <OPTION value=2>Manual</OPTION> 
        <OPTION value=3>Immulite</OPTION> <OPTION value=4>Complement mediated 
        lysis</OPTION> <OPTION value=5>Whole Blood Lysis</OPTION> <OPTION 
        value=6>Flow Cytometry</OPTION> <OPTION value=7>RIA</OPTION> <OPTION 
        value=8>HPLC</OPTION> <OPTION value=9>EIA</OPTION> <OPTION 
        value=10>ELISA</OPTION> <OPTION value=11>Colorimetric</OPTION> <OPTION 
        value=12>IFA</OPTION> <OPTION value=13>Hemagglutination</OPTION> <OPTION 
        value=14>Referred Out</OPTION> <OPTION value=15>Clotting method</OPTION> 
        <OPTION value=16>Radial Immunodiffusion</OPTION> <OPTION value=17>Double 
        immunodiffusion</OPTION> <OPTION value=18>Electrophoresis</OPTION> 
        <OPTION value=19>Automated/Manual</OPTION> <OPTION value=20>manual 
        staining</OPTION> <OPTION value=21>a full range of 
        methodologies</OPTION> <OPTION value=22>a full range of manual and 
        automated methods</OPTION> <OPTION value=23>FPIA</OPTION> <OPTION 
        value=24>MEIA</OPTION> <OPTION value=25>rate reaction</OPTION> <OPTION 
        value=26>Chemiluminometric technology</OPTION> <OPTION value=27 
        selected>Automated method</OPTION> <OPTION value=28>PCR</OPTION> <OPTION 
        value=30>Westergren</OPTION> <OPTION value=29>Fully automated, using a 
        fluorescent dye</OPTION> <OPTION value=31>Westergren</OPTION> <OPTION 
        value=32>Platelet Function Analyzer</OPTION> <OPTION value=33></OPTION> 
        <OPTION value=34>Liatest (immunoturbidimetric)</OPTION> <OPTION 
        value=35>Platelet Aggregometer</OPTION> <OPTION value=36>Urea 
        Solubility</OPTION> <OPTION value=37></OPTION> <OPTION value=38>Immulite 
        2000</OPTION> <OPTION value=39>GC/MS</OPTION> <OPTION 
        value=40>Bioassay</OPTION> <OPTION value=41>Osmotic Pressure</OPTION> 
        <OPTION value=42>RIA/EIA</OPTION> <OPTION value=43>CDC and/or 
        AHG-CDC</OPTION> <OPTION value=44>Bilirubin Meter</OPTION> <OPTION 
        value=45>Nova 8</OPTION> <OPTION value=46>IR-scanner</OPTION> <OPTION 
        value=47>Osmometer</OPTION> <OPTION value=48>Fluorometric</OPTION> 
        <OPTION value=49>Spectrophotometry</OPTION> <OPTION value=50>Enzymatic 
        reaction</OPTION> <OPTION value=51>Ionic Selective Electrode</OPTION> 
        <OPTION value=52>Automated method plus calculation</OPTION> <OPTION 
        value=53>Automated Reagent Strip Reader</OPTION> <OPTION 
        value=54>Magnetic particle ELISA</OPTION> <OPTION 
        value=55>Co-oximeter</OPTION> <OPTION value=56>Electrical resistance 
        corrected sodium method</OPTION> <OPTION value=57>Mass Spec</OPTION> 
        <OPTION value=58></OPTION> <OPTION value=59>High Resolution 
        ICP-MS</OPTION> <OPTION value=60>Non-Dispersive Infrared 
        Spectrometry</OPTION> <OPTION value=61></OPTION> <OPTION 
        value=62>Clotting assays and ELISA</OPTION> <OPTION 
        value=63>Microscopy</OPTION> <OPTION value=64>Electrophoresis and 
        Western Blot</OPTION> <OPTION value=65>Immunochromatographic 
        slide</OPTION> <OPTION value=66>ELISA (Research only)</OPTION> <OPTION 
        value=67>ELISA (Research Only)</OPTION> <OPTION value=68>LC/UV 
        Detector</OPTION> <OPTION value=69>High Resolution ICP-MS</OPTION> 
        <OPTION value=70>TLC (Thin Layer Chromatography)</OPTION> <OPTION 
        value=71>FEIA</OPTION> <OPTION value=72>LC/MSD</OPTION> <OPTION 
        value=73></OPTION> <OPTION value=74>Sudan Stain</OPTION> <OPTION 
        value=75></OPTION> <OPTION value=76>GC/FID</OPTION> <OPTION 
        value=77>HPLC/MSD</OPTION> <OPTION value=78>IRMA</OPTION></SELECT> </td>
    <td><A 
      href="https://intranet.uhn.ca/hospitals_associates/tml/LabDictionary/admin_tool/method.asp?DIVISION_ID=2&amp;alpha=c&amp;TEST_ID=368&amp;method_ID=27"></A></td></tr>
  <tr>
    <td vAlign=center align=right>special instructions:</td>
    <td><TEXTAREA name=Collection_Instructions wrap=VIRTUAL cols=48></TEXTAREA> 
    </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>shipping:</td>
    <td><SELECT name=Shipping_ID> <OPTION value=0>*** select ***</OPTION> 
        <OPTION value=1>Frozen at -20C</OPTION> <OPTION value=2>room 
        temperature</OPTION> <OPTION value=3>0 degrees C</OPTION> <OPTION 
        value=4>big box</OPTION> <OPTION value=5>small box</OPTION> <OPTION 
        value=6>Serum frozen at -70C</OPTION> <OPTION value=7 
        selected>4C</OPTION> <OPTION value=8>Safety Container with cold 
        pack</OPTION> <OPTION value=9>Safety container with cold pack</OPTION> 
        <OPTION value=10>N/A</OPTION> <OPTION value=11>serum or plasma sent 
        frozen at -10C or colder</OPTION> <OPTION value=12>room temperature or 4 
        degree</OPTION> <OPTION value=13>roon temperature or 4c</OPTION> <OPTION 
        value=14>room temperature or 4C</OPTION> <OPTION value=15>Special 
        container from HICL or sent frozen</OPTION> <OPTION value=16>whole blood 
        -EDTA tube</OPTION> <OPTION value=17>frozen serum</OPTION> <OPTION 
        value=18>special container supplied by HICL</OPTION> <OPTION 
        value=19>peripheral blood smear</OPTION> <OPTION value=20>Bone marrow 
        smears, in break proof container</OPTION> <OPTION value=21>37C</OPTION> 
        <OPTION value=22>Wrap aliquot in aluminum foil and send frozen</OPTION> 
        <OPTION value=23>frozen plasma</OPTION> <OPTION value=24>Sample on dry 
        ice</OPTION> <OPTION value=25>Send frozen on dry ice.</OPTION> <OPTION 
        value=26>If &gt;24 hrs, ship frozen at -20C</OPTION> <OPTION 
        value=27>ship at 2-8C</OPTION> <OPTION value=28>Refrigerated 2-8C (send 
        on ice or freeze packs)</OPTION> <OPTION value=29>unseparated at 37C. 
        Separated at room temperature.</OPTION></SELECT> </td>
    <td><A 
      href="https://intranet.uhn.ca/hospitals_associates/tml/LabDictionary/admin_tool/shipping.asp?DIVISION_ID=2&amp;alpha=c&amp;TEST_ID=368&amp;Shipping_ID=7"></A></td></tr>
  <tr>
    <td align=right>
      <P>(web) recommended volume:<BR><B>**important: numeric only - use 'unit 
      of measure' menu below to specify unit**</B> </P></td>
    <td><INPUT size=12 value=2.5 name=webVolume_rec> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>(web) required volume:<BR><B>**important: numeric only - 
      use 'unit of measure' menu below to specify unit**</B> </td>
    <td><INPUT size=12 value=2.5 name=webVolume_req> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>volume measure:</td>
    <td><SELECT name=International_unit_ID> <OPTION value=0>*** select 
        ***</OPTION> <OPTION value=1 selected>mL</OPTION> <OPTION 
        value=2>cm</OPTION> <OPTION value=3>"pass" (aspirate)</OPTION> <OPTION 
        value=4>uL</OPTION> <OPTION value=5>serum and plasma</OPTION> <OPTION 
        value=6>EDTA, microtainer, no gel</OPTION> <OPTION 
      value=7>gm</OPTION></SELECT> </td>
    <td><A 
      href="https://intranet.uhn.ca/hospitals_associates/tml/LabDictionary/admin_tool/unitmeasure.asp?DIVISION_ID=2&amp;alpha=c&amp;TEST_ID=368&amp;International_unit_ID=1"></A></td></tr>
  <tr>
    <td align=right>(web) specimen type:</td>
    <td><SELECT name=Specimen_type_ID> <OPTION value=0>*** select 
        ***</OPTION> <OPTION value=45>Fine Needle Aspirate</OPTION> <OPTION 
        value=1>Body Fluid</OPTION> <OPTION value=2>Bone Marrow 
        aspirate</OPTION> <OPTION value=3>serum</OPTION> <OPTION 
        value=4>Urine</OPTION> <OPTION value=5>plasma</OPTION> <OPTION 
        value=6>citrated plasma</OPTION> <OPTION value=7 selected>Peripheral 
        Blood</OPTION> <OPTION value=8>fresh tissue</OPTION> <OPTION 
        value=9>lesional tissue</OPTION> <OPTION value=10>lesional 
        tissue</OPTION> <OPTION value=11>Stool</OPTION> <OPTION value=12>Please 
        call for specimen details</OPTION> <OPTION value=13>Bone</OPTION> 
        <OPTION value=14>Corneal Scrapping</OPTION> <OPTION value=15>Spinal 
        Fluid</OPTION> <OPTION value=16>Eye Swab</OPTION> <OPTION 
        value=17>Aspirate/Drainage</OPTION> <OPTION value=18>Synovial 
        Fluid</OPTION> <OPTION value=19>Wound Swab</OPTION> <OPTION 
        value=20>Genital specimen</OPTION> <OPTION value=21>Serum and 
        urine</OPTION> <OPTION value=22>Paraffin-embedded material</OPTION> 
        <OPTION value=23>Fine Needle Aspirates and lesional tissue</OPTION> 
        <OPTION value=24>Fine Needle Aspirates and lesional tissue.</OPTION> 
        <OPTION value=25>serum or plasma</OPTION> <OPTION value=26>urine or 
        gastric lavage</OPTION> <OPTION value=27>Container fron HICL or can be 
        sent frozen</OPTION> <OPTION value=28>whole blood -EDTA tube</OPTION> 
        <OPTION value=29>EDTA microtainer, no gel</OPTION> <OPTION value=30>grey 
        stoppered tube</OPTION> <OPTION value=31>Lavender EDTA</OPTION> <OPTION 
        value=32>serum,plasma or whole blood</OPTION> <OPTION value=33>Whole 
        blood(Heparin or EDTA)</OPTION> <OPTION value=34>screw cap 
        container,sterile,90ml</OPTION> <OPTION value=35>Whole blood(Heparin or 
        EDTA)</OPTION> <OPTION value=36>red no additive.</OPTION> <OPTION 
        value=37>grey NAF/K oxalate</OPTION> <OPTION value=38>green,lithium 
        heparin.PST(plasma separator)</OPTION> <OPTION value=39>Urine 24 
        hour</OPTION> <OPTION value=40>peripheral blood smear</OPTION> <OPTION 
        value=41>bone marrow aspirate slides</OPTION> <OPTION 
        value=42>peripheral blood (EDTA)</OPTION> <OPTION value=43>NA</OPTION> 
        <OPTION value=44>Whole Blood (citrate)</OPTION> <OPTION 
        value=46>Breath</OPTION> <OPTION value=47>EDTA Lavender, tissue</OPTION> 
        <OPTION value=48>ACD whole blood and serum</OPTION> <OPTION 
        value=49>Red, no additive or urine</OPTION> <OPTION value=50>Red, no 
        additive, microcontainer</OPTION> <OPTION value=51>Stone</OPTION> 
        <OPTION value=52>Blood, urine (24 hr)</OPTION> <OPTION value=53>Green, 
        lithium heparin, urine (24hr)</OPTION> <OPTION value=54>Dialysate 
        fluid</OPTION> <OPTION value=55>Random or 24 hour urine</OPTION> <OPTION 
        value=56>Fluid or stool</OPTION> <OPTION value=57>ACD (yellow top), 
        whole blood</OPTION> <OPTION value=58>Four green lithium heparin and Two 
        lavender EDTA</OPTION> <OPTION value=59>Royal blue heparinized plasma or 
        Royal blue serum</OPTION> <OPTION value=60>Green, lithium heparin, 10 
        mL</OPTION> <OPTION value=61>Green lithium heparin, 10 mL</OPTION> 
        <OPTION value=62>Heparinized plasma</OPTION> <OPTION value=63>serum or 
        heparinized plasma</OPTION> <OPTION value=64>whole blood in heparinized 
        syringe</OPTION> <OPTION value=65>Red, no additive and random 
        urine</OPTION> <OPTION value=66>Plasma from an EDTA plastic 
        tube</OPTION> <OPTION value=67>Whole blood (Lithium Heparin)</OPTION> 
        <OPTION value=68>Breath</OPTION> <OPTION value=69>Whole Blood 
        (heparinized)</OPTION> <OPTION value=70>Whole Blood 
        (Heparinized)</OPTION> <OPTION value=71>Whole Blood 
        (Heparinized)</OPTION> <OPTION value=72>7mL pink or lavender EDTA /5mL 
        draw (x2)</OPTION> <OPTION value=73>4 yellow ACD and 2- 7mL pink or 
        lavender EDTA</OPTION> <OPTION value=74>6mL pink or 7mL lavender 
        EDTA</OPTION> <OPTION value=75>Gastric Lavage</OPTION> <OPTION 
        value=76></OPTION> <OPTION value=77></OPTION> <OPTION value=78>1-10mL 
        red no additives, or 2-7mL pink EDTA's</OPTION> <OPTION value=79>2 10mL 
        red top</OPTION> <OPTION value=80></OPTION> <OPTION value=81></OPTION> 
        <OPTION value=82>3-red no additive, or 4-7mL pink EDTA</OPTION> <OPTION 
        value=83>Gastric Lavage</OPTION> <OPTION value=84>random 
      urine</OPTION></SELECT> </td>
    <td><A 
      href="https://intranet.uhn.ca/hospitals_associates/tml/LabDictionary/admin_tool/webspecimen.asp?DIVISION_ID=2&amp;alpha=c&amp;TEST_ID=368&amp;Specimen_Type_ID=7"></A></td></tr>
  <tr>
    <td align=right>LIS code:</td>
    <td><INPUT size=12 value=CBC name=LIS_code> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>LOINC code:</td>
    <td><INPUT size=12 name=LOINC_code> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>Display on web site:</td>
    <td><SELECT name=webDisplay> <OPTION>*** select ***</OPTION> <OPTION 
        value=1>yes</OPTION> <OPTION value=2 selected>no</OPTION></SELECT> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>(web) disclaimer:</td>
    <td><SELECT name=webDisclaimer_ID> <OPTION value=0 
        selected>none</OPTION> <OPTION value=1>full service only for 
        Canadian</OPTION></SELECT> </td>
    <td><A 
      onclick="MM_popupMsg('If you require a new disclaimer type or think an exisitng one should be changed, please contact Michele Henry.')" 
      href="javascript:;"></A></td></tr>
  <tr>
    <td vAlign=baseline align=right>test components:<BR><B>**important: 
      separate component tests with commas (testX,testY)**</B> </td>
    <td><TEXTAREA name=Components wrap=VIRTUAL cols=48></TEXTAREA> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right height=5>&nbsp;</td>
    <td align=right height=5>
      <DIV align=left><INPUT type=submit value="update test" name=submit> 
    </DIV></td>
    <td align=right height=5>&nbsp;</td></tr>
  <tr vAlign=baseline align=middle>
    <td vAlign=center bgColor=#333366 colSpan=3 height=5><FONT 
      color=#ffffff>Please review the exisiting database values below for 
      errors, inconsistent formatting, etc.<BR>If you would like to make a 
      change, but are concerned that it may affect the internal systems, please 
      email <A href="mailto:michele.henry@uhn.on.ca"><FONT color=#cccccc>Michele 
      Henry</FONT></A> before making the change.</FONT></td></tr>
  <tr>
    <td align=right colSpan=3 height=10>&nbsp;</td></tr>
  <tr>
    <td align=right>test name:</td>
    <td><INPUT size=48 value="Complete blood count" name=TEST> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>(internal) container:</td>
    <td><SELECT name=CONTAINER_ID> <OPTION value=2>Aspirate 
        container</OPTION> <OPTION value=4>Attest</OPTION> <OPTION 
        value=5>BacT/Alert (FAN aerobic &amp; anaerobic bottles)</OPTION> 
        <OPTION value=6>BactT/Alert bottle paedatrics, yellow</OPTION> <OPTION 
        value=9>Black screw top bijou bottles with 1 mL Ringer's l...</OPTION> 
        <OPTION value=10>Black, buffered sodium citrate, 7.0 mL</OPTION> <OPTION 
        value=12>Blood, Gold SST (serum separator), 7 mL; Urine, co...</OPTION> 
        <OPTION value=13>BM - Bone marrow unfixed film; Blood - Lavender 
        ED...</OPTION> <OPTION value=14>Bone marrow unfixed film</OPTION> 
        <OPTION value=15>Bottle with no additive</OPTION> <OPTION 
        value=16>Bottle with PBS</OPTION> <OPTION value=18>Brown plastic tube, 
        screw cap</OPTION> <OPTION value=19>Chemspores</OPTION> <OPTION 
        value=21>Chlamydia transport</OPTION> <OPTION value=22>Clear plastics 
        tube with attached lids/ screw cap ...</OPTION> <OPTION 
        value=23>Commercial vial / bag</OPTION> <OPTION value=24>Concave 
        slide</OPTION> <OPTION value=25>Culture media</OPTION> <OPTION 
        value=28>EDTA, microcontainer, no gel separator</OPTION> <OPTION 
        value=31>Green, lithium heparin, 7 mL</OPTION> <OPTION value=32>Green, 
        lithium heparin, 7 mL and urine container, ...</OPTION> <OPTION 
        value=33>Green, lithium heparin, PST (plasma separator), 7 ...</OPTION> 
        <OPTION value=34>Green, sodium heparin, 7 mL</OPTION> <OPTION 
        value=36>Grey, NaF/K oxalate, 7 mL draw</OPTION> <OPTION value=37>Grey, 
        NaF/K oxalate, 7 mL draw and Urine container...</OPTION> <OPTION 
        value=38>Heparinized capillary tube</OPTION> <OPTION 
        value=39>Heparinized syringe, 3 mL</OPTION> <OPTION value=41 
        selected>Lavender EDTA, 2.5 mL draw/ 5 mL tube, 3ml draw/5m...</OPTION> 
        <OPTION value=42>Lavender EDTA, 3.0 mL draw/ 5 mL tube</OPTION> <OPTION 
        value=43>Lavender EDTA, 5.0 mL draw/ 7 mL tube (x2)</OPTION> <OPTION 
        value=45>CTAD with blue hemoguard lid, 5 mL draw</OPTION> <OPTION 
        value=47>Occult blood slide</OPTION> <OPTION value=48>Paint can with lid 
        and plastic bag</OPTION> <OPTION value=49>Peritoneal dialysis bags, 
        3L</OPTION> <OPTION value=55>Plastic tube, 5 mL</OPTION> <OPTION 
        value=56>Proofs</OPTION> <OPTION value=57>Gold SST (serum separator), 7 
        mL</OPTION> <OPTION value=60>Red, no additive, 7 mL</OPTION> <OPTION 
        value=61>Red, no additive, microcontainer</OPTION> <OPTION 
        value=62>Royal blue, no additive, 5.0 mL</OPTION> <OPTION value=63>Royal 
        blue, sodium heparin, 5.0 mL</OPTION> <OPTION value=66>Red, no additive, 
        7 mL and a screw cap container, ...</OPTION> <OPTION value=68>Special 
        collection requred. Book with 340-4800 x83...</OPTION> <OPTION 
        value=70>Special: Lavender EDTA, 5.0 mL draw/ 7 mL tube con...</OPTION> 
        <OPTION value=71>Starplex container paddle</OPTION> <OPTION 
        value=72>Starplex SAF</OPTION> <OPTION value=73>Starplex swab placed in 
        transport media provided</OPTION> <OPTION value=74>Starplex swab or 
        prepared slide</OPTION> <OPTION value=78>Syringe - special 
        container</OPTION> <OPTION value=79>Syringe, 25 mL</OPTION> <OPTION 
        value=81>Urine container, 4 L</OPTION> <OPTION value=83>Urine container, 
        4 L, containing 20 mL of 6 mol/L ...</OPTION> <OPTION value=84>Urine 
        container, 4 L, containing 5 g sodium carbon...</OPTION> <OPTION 
        value=85>Urine container, 4 L, containing 7 g tartaric acid</OPTION> 
        <OPTION value=87>Urine container, 4 L or Screw cap container, 
        steri...</OPTION> <OPTION value=88>Urine container, 4 L, washed (soaked) 
        for 4 h with...</OPTION> <OPTION value=90>Viral transport media</OPTION> 
        <OPTION value=91>Yellow/ black top isolater 10 mL (obtain from 
        micr...</OPTION> <OPTION value=92>Yellow ACD, 10 ml tube / 7mL 
        draw</OPTION> <OPTION value=93>-</OPTION> <OPTION value=94>Screw cap 
        container, sterile, 90 mL with small amo...</OPTION> <OPTION 
        value=95>Culture tube</OPTION> <OPTION value=96>Screw cap container, 
        sterile, 90 mL &amp; Anaerobic cu...</OPTION> <OPTION value=98>Screw cap 
        container, sterile, 90 mL, non-bacterios...</OPTION> <OPTION 
        value=99>Prepared slides</OPTION> <OPTION value=100>Culture media &amp; 
        1-3 inoculated glass microscope sl...</OPTION> <OPTION value=101>Black 
        paper in Public Health Lab container</OPTION> <OPTION value=102>Red, no 
        additive, 7 mL (x2)</OPTION> <OPTION value=103>As Directed by Blood 
        Transfusion Lab</OPTION> <OPTION value=104>Green, lithium heparin, 40 mL 
        and Pink or Lavender...</OPTION> <OPTION value=105>Lavender EDTA, 20 
        mL</OPTION> <OPTION value=106>Red, no additive, 7 mL and Lavender EDTA, 
        5 mL</OPTION> <OPTION value=107>Enteric pathogen transport media, 15 ml 
        (EPT 100)</OPTION> <OPTION value=108>Green, lithium heparin, 7 mL 
        (x2)</OPTION> <OPTION value=109>Screw cap container (conical bottom), 
        sterile, 15m...</OPTION> <OPTION value=110>Screw cap container (conical 
        bottom), sterile, 50 ...</OPTION> <OPTION value=111></OPTION> <OPTION 
        value=140>Grey, NaF/K oxalate, 7 mL draw or Green, lithium h...</OPTION> 
        <OPTION value=141>Bacti-alert (FAN aerobic &amp; anaerobic</OPTION> 
        <OPTION value=142>Please call for information</OPTION> <OPTION 
        value=143>done at bedside</OPTION> <OPTION value=144></OPTION> <OPTION 
        value=145>Sterile container</OPTION> <OPTION value=146>Screw cap 90 mL 
        sterile container</OPTION> <OPTION value=147>Discontinued</OPTION> 
        <OPTION value=148>Sterile container of tissue culture medium or 
        ster...</OPTION> <OPTION value=149>ThinPrep Pap Test PreservCyt 
        Vial</OPTION> <OPTION value=150>50 mL screw cap conical centrifuge tube 
        containing...</OPTION> <OPTION value=151>Lavender EDTA or Red, no 
        additive</OPTION> <OPTION value=152>ACD (yellow top) and serum</OPTION> 
        <OPTION value=153>ACD (yellow top), whole blood</OPTION> <OPTION 
        value=154>3.2% (0.109 M) buffered trisodium citrate, 5 ml dr...</OPTION> 
        <OPTION value=155>EDTA, plastic tube</OPTION> <OPTION value=156>Breath 
        Collection bags</OPTION> <OPTION value=157>Lavender EDTA, 3.0 mL draw/ 5 
        mL Tube</OPTION> <OPTION value=158>pink or lavender EDTA 5.0 mL draw/7mL 
        tube ( x2)</OPTION> <OPTION value=159></OPTION> <OPTION value=160>Red, 
        no additive, 10mL ( x3)</OPTION> <OPTION value=161>2 yellow ACD or 2 - 
        7mL pink or lavender EDTA</OPTION> <OPTION value=162>pink EDTA 5.0mL 
        draw/ 6mL tube</OPTION> <OPTION value=163>3 mL EDTA, Lavendar</OPTION> 
        <OPTION value=164>90 mL sterile screw cap container</OPTION> <OPTION 
        value=165>EDTA tube or Heparin tube</OPTION> <OPTION value=166>Red tube 
        or Heparin Tube</OPTION> <OPTION value=167>Supernatant from 2 mL of 
        green top heparin whole b...</OPTION> <OPTION value=168>Lithium heparin, 
        dark green, 7mL</OPTION> <OPTION value=169>Royal Blue, K2 EDTA</OPTION> 
        <OPTION value=170></OPTION> <OPTION value=171></OPTION> <OPTION 
        value=172></OPTION></SELECT> </td>
    <td><A 
      href="https://intranet.uhn.ca/hospitals_associates/tml/LabDictionary/admin_tool/container.asp?CONTAINER_ID=41"></A></td></tr>
  <tr>
    <td vAlign=center align=right>(internal) ALTERNATE container:</td>
    <td vAlign=center><TEXTAREA name=ALT_CONTAINER wrap=VIRTUAL cols=42>Lavender EDTA, 5.0 mL draw/ 7 mL tube</TEXTAREA> 
    </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>synonym1:</td>
    <td><INPUT size=32 value=CBC name=SYNONYM1> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>synonym2:</td>
    <td><INPUT size=32 value="Erythrocyte count, RBC" name=SYNONYM2> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>synonym3:</td>
    <td><INPUT size=32 value="Leukocyte count, WBC" name=SYNONYM3> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right height=35>&nbsp;</td>
    <td vAlign=center height=35><INPUT type=submit value="update test"> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right colSpan=3 height=10>&nbsp;</td></tr><!--Everything below are the'original' database fields - the user can alter info, but is discouraged from doing so; these form items are perhaps obsolete when/if the admin tools merge, and if only one person is responsible for data entry - they can use Sheila's admin tool for these fields -->
  <tr vAlign=baseline align=middle>
    <td vAlign=center bgColor=#333366 colSpan=3 height=50><FONT 
      color=#ffffff>The database values below are used internally.<BR>Please use 
      <B>extreme caution</B> when changing these fields.</FONT></td></tr>
  <tr>
    <td align=right colSpan=3 height=10>&nbsp;</td></tr>
  <tr>
    <td align=right>display on intranet:</td>
    <td><SELECT name=DisplayInternal> <OPTION>*** select ***</OPTION> 
        <OPTION value=1 selected>yes</OPTION> <OPTION value=2>no</OPTION></SELECT> 
    </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>(internal) grant price:</td>
    <td colSpan=2>$ <INPUT size=10 value=6.00 name=GrantPrice> </td></tr>
  <tr>
    <td align=right>critical value:</td>
    <td><INPUT size=32 
      value="Hb; <50g/L; >200g/L |Lkc; <1.0; E+9/L; >50;E+9/L |Plt; <20;E+9/L; >1000; E+9/L |Neutro ; <0.5;E+9/L." 
      name=CRITICAL_VALUE> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>instrument:</td>
    <td><INPUT size=32 value="Cell Dyne 3200,3500,4000" name=INSTRUMENT> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>(internal) specimen type:</td>
    <td><SELECT name=SPEC_TYPE_ID> <OPTION value=2>All body sites / 
        inanimate objects</OPTION> <OPTION value=3>Amniotic fluid</OPTION> 
        <OPTION value=4>Anorectal introital</OPTION> <OPTION value=6 
        selected>Blood</OPTION> <OPTION value=7>Blood, nasal fluid</OPTION> 
        <OPTION value=9>Blood, timed urine</OPTION> <OPTION value=10>Blood, 
        tissue</OPTION> <OPTION value=12>Gastric lavage</OPTION> <OPTION 
        value=13>Blood, urine (24 h)</OPTION> <OPTION value=15>Bone 
        Marrow</OPTION> <OPTION value=16>Body/dialysate fluid other than spinal 
        fluid</OPTION> <OPTION value=17>Bone</OPTION> <OPTION value=18>Bone 
        marrow</OPTION> <OPTION value=19>Bone marrow aspirate</OPTION> <OPTION 
        value=21>Breath</OPTION> <OPTION value=22>Corneal scraping</OPTION> 
        <OPTION value=23>Cyst fluid</OPTION> <OPTION value=24>Dialysate 
        fluid</OPTION> <OPTION value=25>Duodenal aspirate</OPTION> <OPTION 
        value=26>Eye</OPTION> <OPTION value=27>Eye fluid</OPTION> <OPTION 
        value=28>Fluid</OPTION> <OPTION value=30>Fluid on Starplex swab</OPTION> 
        <OPTION value=31>Fluid, stool</OPTION> <OPTION value=33>Joint 
        fluid</OPTION> <OPTION value=34>Lesion fluid</OPTION> <OPTION 
        value=36>Nasopharyngeal fluid</OPTION> <OPTION value=41>Urine, 
        random</OPTION> <OPTION value=43>Respiratory fluid</OPTION> <OPTION 
        value=44>Skin</OPTION> <OPTION value=45>Skin, fluid</OPTION> <OPTION 
        value=47>Serum with Spinal fluid</OPTION> <OPTION 
        value=48>Stone</OPTION> <OPTION value=49>Stool</OPTION> <OPTION 
        value=50>Synovial fluid</OPTION> <OPTION value=52>Urine, timed</OPTION> 
        <OPTION value=53>Tissue</OPTION> <OPTION value=54>Tissue biopsy</OPTION> 
        <OPTION value=55>FNA</OPTION> <OPTION value=56>Tissue, fresh</OPTION> 
        <OPTION value=58>Urine, 24 h or random</OPTION> <OPTION value=59>Urine 
        24 h</OPTION> <OPTION value=64>Worm, insect</OPTION> <OPTION 
        value=65>-</OPTION> <OPTION value=67>Vesicle fluid</OPTION> <OPTION 
        value=68>Abscess / aspirates</OPTION> <OPTION value=69>Midday 
        urine</OPTION> <OPTION value=70>Needle aspirate</OPTION> <OPTION 
        value=71>Vaginal</OPTION> <OPTION value=72>Inanimate objects</OPTION> 
        <OPTION value=73>Brushes</OPTION> <OPTION value=74>Wounds</OPTION> 
        <OPTION value=75>Respiratory tissue</OPTION> <OPTION value=76>Skin 
        Scrapings</OPTION> <OPTION value=77>Attest</OPTION> <OPTION 
        value=78>Chemspores</OPTION> <OPTION value=79>Commercial bags, 
        vials</OPTION> <OPTION value=80>Proof</OPTION> <OPTION 
        value=81>Genital</OPTION> <OPTION value=82>Respiratory swabs</OPTION> 
        <OPTION value=83>Genital / reproductive</OPTION> <OPTION 
        value=84>Tissue, paraffin-embedded</OPTION> <OPTION value=85>Blood cell 
        collection</OPTION> <OPTION value=86>Post Transfusion Blood sample plus 
        the offending product bag (donor unit)</OPTION> <OPTION value=87>Urine, 
        first morning</OPTION> <OPTION value=88>Specify specimen</OPTION> 
        <OPTION value=89>peripheral blood smear</OPTION> <OPTION 
        value=90>peripheral blood smear</OPTION> <OPTION value=91>Whole 
        Blood</OPTION> <OPTION value=92>Lavender EDTA or Red, no additive 
        (dependent on type of test)</OPTION> <OPTION value=93>CSF</OPTION> 
        <OPTION value=94>Bone Core Biopsy</OPTION> <OPTION value=95>Cultured 
        Cells</OPTION> <OPTION value=96>Cytology - Gyn</OPTION> <OPTION 
        value=97>Cerebrospinal Fluid</OPTION> <OPTION value=98>Cytology - Non 
        Gyn</OPTION> <OPTION value=99></OPTION> <OPTION value=100>ACD (yellow 
        top), whole blood</OPTION> <OPTION value=101>Red, no additive</OPTION> 
        <OPTION value=102>Blood and random urine</OPTION> <OPTION 
        value=103>Blood and random urine</OPTION> <OPTION value=104>Serum or 
        Plasma</OPTION> <OPTION value=105>serum</OPTION> <OPTION 
        value=106>Supernatant of centrifuged, precipitated heparinized 
        blood</OPTION> <OPTION value=107>supernatant</OPTION> <OPTION 
        value=108>Blood and Apheresis Product</OPTION></SELECT> </td>
    <td><A 
      href="https://intranet.uhn.ca/hospitals_associates/tml/LabDictionary/admin_tool/specimentype.asp?SPEC_TYPE_ID=6"></A></td></tr>
  <tr>
    <td align=right>(internal) submit specimen:</td>
    <td><INPUT size=32 value="Central Lab/Specimen Management" 
      name=SUBMIT_SPEC> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>(internal) patient preparation</td>
    <td><INPUT size=32 name=PATIENT_PREP> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>(internal) minimum volume (at ward):</td>
    <td><INPUT size=32 value="2.5 ml (Full draw)" name=MIN_VOL_WARD> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>(internal) minimum volume (at lab):</td>
    <td><INPUT size=32 value="1 mL" name=MIN_VOL_LAB> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>(internal) store temp (pre):</td>
    <td><INPUT size=32 value="Room temperature" name=STORE_TEMP_PRE> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>(internal) store temp (post):</td>
    <td><INPUT size=32 value="4 C, 2 d" name=STORE_TEMP_POST> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>(internal) reference range:</td>
    <td><INPUT size=32 
      value=Hb;140-180;g/L;M;;Hb;120-160;g/L;F|Lkc;4.0-11.0;E+9/L;;;;;;|Plt;150-400;E+9/L;;;;;;|MCV;80-95;fL;;;;;;|RDW;11.5-14.8;;;;;;;|ERC;4.5-6.5;E+12/L;M;;ERC;3.9-5.6;E+12/L;F|PCV;0.40-0.54;L/L;M;;PCV;0.33-0.47;L/L;F|MCH;27.0-32.0;pg;;;;;;|MCHC;320-360;L/L;;;;;;|NEUT;2.0-7.5;E+9/L;;;;;;|LYMPH;1.5-4.0;E+9/L;;;;;;|MONO;0.2-0.8;E+9/L;;;;;;|EOS;0.04-.4;E+9/L;;;;;;|BASO;0.01-0.1;E+9/L;;;;;; 
      name=REF_RANGE> </td>
    <td><A 
      onclick="MM_popupMsg('Multiple reference ranges are separated by a system of colons &amp; semi-colons. Please contact Michele Henry if you are uncertain how to format this field.')" 
      href="javascript:;"></A></td></tr>
  <tr>
    <td align=right>(internal) reference out:</td>
    <td><INPUT size=32 name=REF_OUT> </td>
    <td><A 
      onclick="MM_popupMsg('Multiple reference ranges are separated by a system of colons &amp; semi-colons. Please contact Michele Henry if you are uncertain how to format this field.')" 
      href="javascript:;"></A></td></tr>
  <tr>
    <td align=right>(internal) special handling:</td>
    <td><INPUT size=32 name=SPEC_HAND> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>(internal) turn-around-time:</td>
    <td><INPUT size=32 value="Stat 1 h; Routine 3 h" name=TAT_STAT> </td>
    <td><A 
      onclick="MM_popupMsg('Please separate multiple turn around times with semi-colons (;).')" 
      href="javascript:;"></A></td></tr>
  <tr>
    <td align=right>(internal) division:</td>
    <td><SELECT name=DIVISION_ID> <OPTION value=1>Chemistry</OPTION> <OPTION 
        value=2 selected>Hematology</OPTION> <OPTION 
        value=3>Microbiology</OPTION> <OPTION value=4>Pathology</OPTION> <OPTION 
        value=5>Blood Transfusion</OPTION> <OPTION value=30>Molecular 
        Genetics</OPTION></SELECT> </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right>(internal) functional area:</td>
    <td><SELECT name=FUNC_AREA_ID> <OPTION value=1>Chemistry 
        Automated</OPTION> <OPTION value=2>Bacteriology</OPTION> <OPTION 
        value=3>Bone Marrow/ PMH</OPTION> <OPTION value=4>Coagulation</OPTION> 
        <OPTION value=5>Cytogenetics</OPTION> <OPTION value=6>Diagnostic 
        Developmental Lab/ TWH</OPTION> <OPTION value=7>Flow Cytometry</OPTION> 
        <OPTION value=8>Immunology</OPTION> <OPTION value=9>Immunology/ 
        Referred-out</OPTION> <OPTION value=10>Immunopathology/ TWH</OPTION> 
        <OPTION value=11>Chemistry Manual</OPTION> <OPTION value=12>Chemistry 
        Manual/ Immunology</OPTION> <OPTION value=13>Parasitology</OPTION> 
        <OPTION value=14>Rapid Response Laboratory</OPTION> <OPTION 
        value=15>Chemistry Referred Out</OPTION> <OPTION value=16 
        selected>Hematology Routine</OPTION> <OPTION value=17>Virology 
        Serology</OPTION> <OPTION value=18>Specimen Management</OPTION> <OPTION 
        value=19>Urinalysis</OPTION> <OPTION value=20>Virology</OPTION> <OPTION 
        value=21>Blood Transfusion</OPTION> <OPTION value=22>Blood Transfusion 
        Serology</OPTION> <OPTION value=23>Blood Transfusion Referred 
        Out</OPTION> <OPTION value=24>HLA</OPTION> <OPTION 
        value=25>histopathology</OPTION> <OPTION value=26>Cytopathology</OPTION> 
        <OPTION value=27>Molecular Diagnostics</OPTION> <OPTION value=28>Mass 
        Spec Lab - TGH site</OPTION> <OPTION value=29>Immunoassay</OPTION> 
        <OPTION value=30>Bone Marrow Bench (PMH)</OPTION> <OPTION 
        value=31></OPTION></SELECT> </td>
    <td><A 
      href="https://intranet.uhn.ca/hospitals_associates/tml/LabDictionary/admin_tool/functionalarea.asp?FUNC_AREA_ID=16"></A></td></tr>
  <tr>
    <td align=right>(internal) Ulticare requisition:</td>
    <td><SELECT name=ULT_REQ_ID> <OPTION value=31>Order on UHN Clinical 
        Desktop</OPTION> <OPTION value=2>Lab orderable</OPTION> <OPTION 
        value=3>Misc req</OPTION> <OPTION value=32>Order in Vista/Blkood 
        Transfusion or Blood Transfusion Requisition</OPTION> <OPTION 
        value=5>Vista / Biochemistry</OPTION> <OPTION value=6>Ulticare/ Flow 
        Cytometry</OPTION> <OPTION value=7>Ulticare/ Hematology</OPTION> <OPTION 
        value=8>Ulticare/ Hematology - Lab orderable</OPTION> <OPTION 
        value=9>Ulticare/ Hematology/ Coagulation</OPTION> <OPTION 
        value=10>Ulticare/ Hematology/ Routine Coagulation</OPTION> <OPTION 
        value=11>Ulticare/ Hematology/ Special Coagulation</OPTION> <OPTION 
        value=12>Ulticare/ Immunoassay</OPTION> <OPTION value=13>Ulticare/ 
        Immunoassay (IVF use IVF req)</OPTION> <OPTION value=14>Vista/ 
        Immunology</OPTION> <OPTION value=15>Vista / Pathology</OPTION> <OPTION 
        value=16>-</OPTION> <OPTION value=17>Ulticare/ Microbiology</OPTION> 
        <OPTION value=18>PHL HIV Serology Testing Requisition</OPTION> <OPTION 
        value=19>PHL Testing Requisition</OPTION> <OPTION value=20>Microbiology 
        Req (TGH/TWH) / Misc req</OPTION> <OPTION value=21>Blood Transfusion 
        Requisition</OPTION> <OPTION value=22>Blood Transfusion Prenatal 
        Req</OPTION> <OPTION value=23>Blood Tranfusion Cord Blood Req</OPTION> 
        <OPTION value=24>CBS HLA/Platelet Form TFHL: 013</OPTION> <OPTION 
        value=25>CBS Form TFHL:013</OPTION> <OPTION value=26>CBS Req</OPTION> 
        <OPTION value=27>CBS Req</OPTION> <OPTION value=28>St. Mike's Platelet 
        Antibody Test Req</OPTION> <OPTION value=29>CBS Misc</OPTION> <OPTION 
        value=30>Vista / Immunoassay</OPTION> <OPTION value=33>Order in 
        Vista/Blood Transfusion or on Blood Transfusion Requisition.</OPTION> 
        <OPTION value=34>Order in EPR/Blood Transfusion or Blood Transfusion 
        Requisition.</OPTION> <OPTION value=35>Must be approved by the Medical 
        Director of Blood Transfusion. Blood Transfusion Lab 
        Requisition</OPTION> <OPTION value=36></OPTION> <OPTION 
        value=37></OPTION> <OPTION value=38></OPTION> <OPTION value=39>Must be 
        approved by the Blood Transfusion Medical Director. CBS 
        Requisition.TFHL: 013</OPTION> <OPTION value=40>Multi-Organ Transplant 
        Requisition</OPTION> <OPTION 
        value=41>Vista/Hematology/Coagulation</OPTION> <OPTION value=42 
        selected>UCD/Hematology</OPTION> <OPTION value=43>Flow 
        Cytometry</OPTION> <OPTION value=44>Multiorgan Transplant Requisition or 
        Bone Marrow Requisition</OPTION> <OPTION value=45>Must be requested by 
        Hematopathologist/Pathologist - Lab Orderable only</OPTION> <OPTION 
        value=46></OPTION> <OPTION value=47>CBS HLA/Platelet Form TFHL: 
        013</OPTION> <OPTION value=48></OPTION> <OPTION 
      value=49></OPTION></SELECT> </td>
    <td><A 
      href="https://intranet.uhn.ca/hospitals_associates/tml/LabDictionary/admin_tool/ulticarereq.asp?ULT_REQ_ID=42"></A></td></tr>
  <tr>
    <td align=right>(internal) downtime requisition:</td>
    <td><SELECT name=DOWN_REQ_ID> <OPTION value=1>Bone Marrow Req</OPTION> 
        <OPTION value=2>Chem A</OPTION> <OPTION value=3>Chem B</OPTION> <OPTION 
        value=4>Quantitative Urine Chemistry</OPTION> <OPTION value=5>Chemistry 
        - Urinalysis</OPTION> <OPTION value=6 selected>Hematology Req</OPTION> 
        <OPTION value=7>Immunoassay A</OPTION> <OPTION value=8>Misc</OPTION> 
        <OPTION value=9>TDM</OPTION> <OPTION value=12>-</OPTION> <OPTION 
        value=13>Microbiology Req (TGH/TWH) / Misc Req</OPTION> <OPTION 
        value=14>PHL HIV Serology Testing Requsition</OPTION> <OPTION 
        value=15>PHL Testing Requistion</OPTION> <OPTION value=16>Blood 
        Gases</OPTION> <OPTION value=50>Genetic Repository req</OPTION> <OPTION 
        value=51>Form 2164</OPTION> <OPTION value=52></OPTION> <OPTION 
        value=53></OPTION> <OPTION value=54>Form 2432</OPTION> <OPTION 
        value=55>Form 2433</OPTION> <OPTION value=56>CBS HLA/Platelet form 
        TFHL:013</OPTION> <OPTION value=57>CBS form- TFHL::013</OPTION> <OPTION 
        value=58></OPTION> <OPTION value=59>Form 2129</OPTION></SELECT> </td>
    <td><A 
      href="https://intranet.uhn.ca/hospitals_associates/tml/LabDictionary/admin_tool/downtimereq.asp?DOWN_REQ_ID=6"></A></td></tr>
  <tr>
    <td align=right>(internal) information call#:</td>
    <td><INPUT size=32 value="Call Centre at 14-LABS (5227)" name=INFO_CALL> 
    </td>
    <td>&nbsp;</td></tr>
  <tr>
    <td align=right height=35>&nbsp;</td>
    <td vAlign=center height=35><INPUT type=submit value="update test"> </td>
    <td>&nbsp;</td></tr>
  <tr>
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